Training in Dengue Prevention and Control

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DESCRIPTION (provided by applicant): This is a revision of a Fogarty training grant proposal "Training in Dengue Prevention and Control" submitted in September of 2009 to build an international infectious disease training program for Mexican predoctoral and postdoctoral students at Colorado State University. The focus of the proposed GIDRTP is to provide critical training in modern approaches for control of the dengue virus (DENV1-4) mosquito vector Aedes aegypti and subsequent prevention of epidemic dengue fever (DF) and Dengue Hemorrhagic Fever (DHF). Both diseases have emerged as major public health problems in the Americas. This proposal was originally submitted last year in conjunction with an application for an International Collaborations in Infectious Disease Research (ICIDR) grant "Sustainable control of Aedes aegypti and epidemic dengue." That ICIDR grant, a collaboration with coinvestigators Dra A. Flores-Suarez from UANL in Monterrey, and Dr. Farfan-Ale from UADY in Merida was awarded and began in September 2010. Thus, if this Fogerty application is funded, we are poised to continue to train pre- and postdoctoral student from Mexico in the most up to date methods to control the Ae. aegypti and subsequent prevention of DF and DHF. The proposed training program will be flexible and will permit specialized coursework and laboratory or field projects in one of four tracks: 1) mosquito monitoring and control, 2) insecticide resistance management, 3) effector molecule development or 4) genetic control. Despite this flexibility all students will become directly involved in populating the Dengue Decision Support System (DDSS) which is being actively developed at CSU with data on dengue patients, laboratory diagnostics, mosquito abundance, and insecticide resistance collected in real time. The DDSS aims to support operational vector/disease control programs by increasing their capacity to: 1) collect, store, manage, and analyze mosquito vector- and disease-related data, 2) produce informative analysis outputs (charts, graphs, maps, tables) to support decision-making, and 3) implement locally appropriate vector/disease control program strategies and methodologies. Ultimately students may also become responsible for establishing and maintaining the DDSS in their own states upon their return to Mexico. PUBLIC HEALTH RELEVANCE: In Mexico and most of Latin America, dengue has re-emerged as a public health problem. The most recent dengue epidemic in Mexico during 2005-2008 resulted in more than 100,000 reported Dengue Fever (DF) cases and >22,000 and Dengue Hemorrhagic Fever (DHF) cases. This is in stark contrast to dengue outbreaks in the 1980's and 1990's which resulted in very few DHF cases. Most of Latin America is now in a very dangerous situation with dengue hyper- endemnicity and increasing disease severity. The focus of this training grant is to provide critical training in modern approaches for control of the dengue virus (DENV1-4) mosquito vector Aedes aegypti and subsequent prevention of epidemic DF and DHF. Current control measures used against Ae. aegypti include source reduction and larvicidal control to reduce larval populations and space spraying to control adults. However, these have not proven to be sufficient or sustainable to stem the tide of DF and DHF. New approaches and tools are sorely needed to control Ae. aegypti in Latin America and indeed most of the tropical and subtropical world.